Basic Information
| Provider Information | |||||||||
| NPI: | 1669048104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAYNARD | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | RIETH | ||||||||
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| Credential: | FNP-BC PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28 AMES RD | ||||||||
| Address2: | |||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079602954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082511811 | ||||||||
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| Practice Location | |||||||||
| Address1: | 274 S ORANGE AVE | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737326040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2021 | ||||||||
| LastUpdateDate: | 06/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 26NJ01052700 | NJ | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.